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Biomedical subjects

J C Frich

Publications and source records attributed to J C Frich.

At least 19 recordsLinked to original sources
PubMed2000

[Medicine and literature--interpretation and discussion of literary texts in medical education].

BACKGROUND: In medical education, using literary texts as a starting point for discussion and reflection, is now quite common. Lectures and seminars in literature and medicine have been given at the University of Oslo since 1996. We describe our pedagogical approach as a "thematic interpretation and discussion of literary texts", theoretically grounded in reader-oriented criticism and problem-based learning (PBL). This article describes the kind of learning taking place during analysis and discussion of literary texts among medical students. MATERIAL AND METHODS: We evaluated a series of four elective seminars for first and second year students in the autumn 1998. We used qualitative approaches based on analysis of material from observations during seminars, reflections written by participants, and notes from a group interview at the end of the seminars. RESULTS: Analysis and discussion of literary texts may give medical students: A better understanding of communicative aspects in the doctor-patient-relationship. Experience with interpretation of narratives and insight into how differently we may interpret a story. Awareness of aspects and dilemmas related to being a doctor. Understanding of how people may experience illness and health. INTERPRETATION: Lectures and seminars on literary texts might be an important supplement to other practical or theoretical teaching for medical students.

Communication↗
PubMed1998

[An enemy of the people--Ibsen as a teacher of public health].

This article is a study of the play An Enemy of the People (1882) by Henrik Ibsen (1828-1906). One of its main characters, Dr Tomas Stockmann, has a crucial role in the discussion about the medical conditions at the public baths. Four excerpts from the play is presented for further discussion. The focus of this article is on Dr Stockmann's work as a public health physician: What causes Dr Stockmann's failure in bringing his report on the medical conditions at the baths to the public? What can physicians in general learn from Dr Stockmann? The article concludes that Dr Stockmann richly illustrates communicative failure and that he is a complex figure, provocative as well as inspiring--something in between a medical savage and a public health hero.

Drama↗
PubMed1996

Dose distributions through the supraclavicular-axillary region of patients undergoing breast cancer treatment.

The supraclavicular-axillary region is often irradiated if multiple lymph nodes are found to be positive in the staging of breast cancer. The doses delivered to supraclavicular-axillary region are typically computed using IRREG program. As such, the dose distributions through these regions are rarely examined. The intent of this study is to examine dose distributions through the supraclavicular-axillary region. The results of this study indicate that the anterior region of the axilla receives about 20% more dose than the supraclavicular region or the mid-axillary point. This excess dose results from the posterior axillary field used to supplement the dose from the supraclavicular-axillary field.

Axilla↗
PubMed1995

[In search of medicine in literature. An introduction to the field of literature and medicine].

In the last two decades increasing academic interest has been shown for the field of literature and medicine. This article introduces the field, and outlines different approaches. Teaching literature in medical education may help physicians and medical students to develop skills and insight of importance for good understanding and practice of their profession. Literary theories may contribute to the understanding of medical practice.

Education, Medical↗
PubMed1995

[Confidentiality in HIV-infection/AIDS--a comment on the Communicable Disease Control Act].

The new Communicable Diseases Control Act has come into force in Norway. It makes it compulsory for a physician to warn a third party if it is obvious that a HIV-positive patient, with a high degree of certainty, puts the third party at risk of being infected with HIV. Some philosophers characterize medical confidentiality as an intransigent and absolute obligation, others as a prima facie duty. This article supports the latter view, but the author still argues that strict conditions have to be fulfilled before a physician should consider breaking medical confidentiality: The doctor must try repeatedly to gain the consent or co-operation of the patient involved. Possible negative long-term consequences for the preventive HIV-work support strict medical confidentiality.

Acquired Immunodeficiency Syndrome↗
PubMed1988

A study of factors contributing to the development of osteoradionecrosis of the jaws.

The histories of 14 patients in whom osteoradionecrosis developed were compared with those of 28 patients who had similar tumors and/or treatment and were not afflicted with osteoradionecrosis. 1. Fourteen of 15 episodes of bone complications occurred in the mandible, and 70% occurred within 1 year after the completion of radiation therapy. 2. A high dose of radiation, with conventional fractionation, did not specifically predispose patients to osteoradionecrosis. Fifty percent of the ORN patients actually received a total dose of 6000 rad or less. Combined radiation therapy and surgery did not seem to significantly increase the risk inasmuch as both groups of patients had similar combinations. In two of four patients who received methotrexate, however, osteoradionecrosis developed during the time of administration. 3. One of the most prevalent negative factors associated with the ORN patients was the continued heavy use of alcohol and tobacco by 86% of them. These strong tissue irritants could have significantly contributed to the breakdown of mucosa and exposure of bone. Alcohol and tobacco could also have potentiated the combined effects of the other negative factors, such as contributing to poor oral hygiene. 4. The ORN patients had poorer oral hygiene than the control group. Seventy-five percent of the patients with teeth who had osteoradionecrosis continued to have poor oral hygiene. In contrast, none of the control patients had poor oral hygiene. 5. A combination of factors relating to stage of tumor and treatment was found in the ORN patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Nd:YAG laser followed by radiation for treatment of malignant airway lesions.

Patients with malignant obstructive airway lesions often present with total or segmental atelectasis of lung. In spite of prompt initiation of palliative external radiation alone, some patients were unable to complete the planned course of radiation therapy. Since May 1983, 17 patients with malignant obstructive endobronchial lesions have been treated by endoscopic Nd:YAG laser vaporization of the tumor. One to seven days later, fractionated external radiation therapy was initiated. Endoscopic use of the laser was repeated as needed during the course of treatment. Fifteen out of 17 patients successfully completed the planned course of therapy. The improved performance status was sustained in 13 of 15 patients for 2-13 months. A control group was selected from among patients with similarly located lesions who underwent external radiation treatment only prior to the availability of the Nd:YAG laser therapy. One patient developed radiation pneumonitis six weeks after completion of a second course of external radiation, another patient developed bronchopleural fistula after laser treatment which healed following closed chest tube drainage. The others had longer palliation of symptoms and improved quality of life. The results indicate that relief of airway obstruction by use of the Nd:YAG laser improved the patients' ability to tolerate subsequent external radiation treatment.

Bronchial Neoplasms↗
PubMed1982

Treatment of advanced squamous carcinoma of the maxillary sinus by irradiation.

Between 1959 and 1972, there were 23 patients with advanced squamous carcinoma of the maxillary sinus treated by radiation therapy as the only modality. Eighteen of these patients had not shown evidence of metastasis and were locally extensive being classified as T3 4N0M0. They received 60-75 Gy (6000-7500 rad) in 6 to 7 1/2 weeks using an anterior portal with opposed lateral wedge pairs to give a homogenous dose. No treatment was given to the neck. Of 10 patients with tumors presenting in the suprastructures, six are living 5 years with no evidence of disease (NED), one is dead of intercurrent disease, one died of metastatic disease with no evidence of tumor at the primary site, and two died of recurrent primary tumor. With suprastructure presentation, radiation therapy as a sole treatment was able to control the primary tumor in eight out of 10 patients. In eight patients in whom the tumor presented in the infrastructure only, one patient was living at 5 years, but this patient had salvage irradiation. One patient died of metastasis but with no evidence of tumor at the primary site. Therefore, six out of eight had uncontrolled or recurrent primary tumor leading to death. It is concluded that in extensive tumors of suprastructure, radiation may be the only modality required to control the primary tumor (80%). In the infrastructure, radiation has failed in 75% of the patients so that surgery may also be required as a planned part of treatment in order to control the primary tumor. Metastatic disease accounted for three of the 10 deaths as a result of tumor.

Carcinoma, Squamous Cell↗
PubMed1976

Urinary cholesterol. VIII. Its excretion in women with ovarian neoplasms.

The urinary excretion of nonesterified cholesterol (NEC) has been investigated in 57 women with ovarian neoplasms and/or related nonneoplastic diseases. Twelve patients had benign tumors or lesions and 45 had malignant neoplasms of their ovaries. All patients with nonmalignant ovarian tumors or lesions had normal NEC excretion irrespective of the type of tumor or lesion or its degree of extension. In contrast, urinary NEC hyperexcretion occurred with the following frequencies in patients with active malignant ovarian neoplasms: 18 of 19 cystadenocarcinomas of the serous and/or mucinous types; one of one endometrioid carcinoma; four of four malignant granulosa cell tumors; two of two mixed malignant germ cell tumors; and one of one malignant mixed müllerian tumor. Single cases of clear cell carcinoma and of rhabdomyosarcoma had a normal NEC excretion. Urinary hyperexcretion of NEC was also found after surgery in two of seven surviving patients with apparently localized resectable disease according to their staging. It is possible that in these two patients NEC hyperexcretion was due to undetected foci of cancer (wrong staging), since neither omental and peritoneal biopsies, nor cytologic examination of peritoneal washings or free fluid were performed. A normal excretion of urinary NEC has been characteristic of 19 of 21 surviving patients treated by surgery and adjunctive therapy in whom we have performed follow-up NEC determinations. They were 16 of 18 cystadenocarcinomas malignant germ cell tumor. The 94% correlation between the presence of proven active ovarian carcinomas and urinary NEC hyperexcretion is significant. The clinical significance of this investigation is even greater when one considers that cystadenocarcinomas constitute more than 75% of all primary malignant ovarian tumors.

Adenocarcinoma↗
PubMed1975

Urinary cholesterol. VII. The significance of the excretion of nonesterified cholesterol in patients with uterine carcinomas.

The urinary excretion of nonesterified cholesterol (NEC) in 170 women with cervical and endometrial carcinomas has been investigated. Control patients (236) included: 1) women with other types of (benign and/or malignant diseases of the pelvic organs; 2) patients with non-steroid-related neoplasms; 3) patients with benign and/or malignant breast diseases other than carcinoma; and 4) patients with a variety of non-neoplastic diseases. NEC was determined by a gas-liquid chromatographic procedure. The range of NEC excretion for clinically healthy normal women (64) was previously established by this method. NEC hyperexcretion was defined as any NEC value over 1.5 mg/24 hours. The results showed NEC hyperexcretion in 65 of 68 women with active carcinoma of the cervix, including 13 patients with carcinoma in situ, and in 42 of 45 women with active carcinoma of the endometrium. In contrast, a normal excretion of NEC occurred in all the patients (77) of the first and second control groups, in 39 (80%) of the 48 patients of the third control group (high-risk group), and in 101 of the 111 patients of the fourth control group. Sequential studies performed in patients with uterine carcinomas have demonstrated an almost perfect correlation between the NEC excretion and the clinical status of the patient following surgical and/or radiation therapy. Of 57 patients (31 cervix and 26 endometrium) in which the NEC studies were started after treatment was instituted, 53 have normal NEC excretion in the multiple determination performed to date. Presently these patients have no clinical, chemical, or radiologic evidence of cancer. It is concluded that urinary NEC determination can be used as an additional diagnostic biochemical test to detect active carcinoma of the steroid-producing glands and their main target organs, and that in women with uterine carcinomas, the test can be used as an objective laboratory method to monitor the course of the disease and the response of the patient to therapy.

Breast Diseases↗